HLTC03 LECTURE 6.docx

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2 Apr 2012
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LECTURE 6
Influences on Health Policy
Political and Economic Context of Health Care Policy
Types of public policy theories
Consenses (rational)
o Pluralism
o Public choice
o New institutionalism
Rational choice
Sociological
Historical
Critical - political ideology, state, power
o Structural (marxism)
o Grand theory
o Political economy
o Feminist political economy
Peter hall's policy paradigms
o Policy paradigms: different types of policy outcomes
o Paradigm: realm of discourse in which policymakers
Peter hall's policy paradigms
o Social learning: he sees ideas as seen as important
Role of ideas in public policymaking process
What do ideas used in this process? what processes are informing policy change
o Distinguish btw learning processes associated with normal and radical policy change
Peter Hall's policy Paradigms
o Typology of policy change:
First -order change
Slight adjustment - increasing doctors fees, resources for community
Second-order change
Changes in incremental changes. e.g. smoking, lets use public education campaign
to tell them shouldn’t start smoking. Hoping to target young people that pick up
smoking. But they have found that this isn't working. Maybe we should tax! Tax
cigarettes and may lead to not purchasing
Third-order change
Radical change - we moved from biomedical approach to health to a social
determinants of health perspective. Looking at broader working and living
conditions.
Advocacy coalition Framework
o Deep core
Advocacy groups knowledge and understanding
o Policy core
Actual policy decisions
o Secondary aspects
What kinds of evidence they bring to change policy
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